Cerebral Fluid in Alzheimer’s Disease

Alzheimer’s disease, also called senile dementia of Alzheimer’s type or simply Alzheimer’s, is a neurodegenerative disease that manifests as cognitive impairment and behavioral disorders. It is characterized in its typical form by a loss of immediate memory and other mental abilities (such as higher cognitive abilities), as nerve cells (neurons) die and different areas of the brain atrophy. The disease usually has an approximate average duration-after diagnosis-of 10 years, although this may vary in direct proportion to the severity of the disease at the time of diagnosis.

Alzheimer’s disease is the most frequent dementia and is a neurodegenerative pathology that already affects more than 1 million people in Spain. Until 2011 the diagnostic criteria were mainly based on clinical aspects, so the patient had to be already in the dementia phase so that a diagnosis could be established. It was also necessary to perform the differential diagnosis with other neurodegenerative dementias or with psychiatric disorders, since many symptoms can be very similar.

For the prevention of Alzheimer’s, several behavioral habits have been suggested, but there is no published evidence that highlights the benefits of those recommendations, including mental stimulation and a balanced diet. The role played by the subject’s caregiver with Alzheimer’s is fundamental, even though the pressures and physical demands of such care can become a great personal burden.

The International Alzheimer’s Day is celebrated on September 21, the date chosen by the WHO and the International Alzheimer’s Federation, in which activities are carried out in various countries to raise awareness and help prevent the disease.

The diagnostic revolution has come hand in hand with the appearance of biomarkers in cerebrospinal fluid such as beta amyloid protein (related to the appearance of senile plaques) and tau protein (reflects neuronal degeneration). Such has been its impact that in the clinical guidelines of the National Institute on Aging Alzheimer’s Association of 2011 have been incorporated into the diagnostic criteria.

The amyloid beta protein is altered for years, even decades, before the onset of symptoms allowing diagnosis in preclinical phases. It has been observed that the group of patients in whom the use of biomarkers would be indicated would be those under 80 years of age, especially those younger than 65 years and also those patients with atypical presentations of the disease or with a more complex diagnosis.

Even seeing the great utility of these biomarkers, its use is not generalized in all the care centers of the country since until relatively recently they were relegated to the field of research. One of the impediments to its limited use is the great variability of the results between the different laboratories since there are many critical points that affect the result such as the collection, handling or storage of the sample. Another obstacle to overcome is the fear of performing lumbar punctures as it is considered an invasive technique, although the safety of the technique is currently high and post-puncture headache occurs in a minority of cases.

Possibly the most important interventions in the coming years will be linked to identifying people at risk of suffering from this dementia through simple tests and even linked to genetics, so that multimodal actions can be established that improve the prognosis of the disease. The possibility of making a diagnosis when the patient is still autonomous and does not have dementia has an impact on the therapeutic management, while allowing the patient and his family to have better information and to be able to make decisions about the future.

In Kalstein we have equipment that allows the determination of proteins, such as fluorometers. These perform a high sensitivity fluorescent detection for the quantification of these biomolecules. That’s why we invite you to take a look at HERE